4 Ways to Stop Picking at Your Skin During a Flare-Up
Ask anyone with psoriasis and they’ll tell you that one of the hardest parts of daily life with the condition is resisting the temptation to pick at their skin. Whether your skin is itchy or not (and up to 90 percent of people with psoriasis do experience itch, according to the National Psoriasis Foundation), sometimes, the urge to rub and peel at thick plaques of skin cells is irresistible.
“I try really hard not to pick at my plaques,” says Molly Campbell, 31, from Cleveland, Ohio. “But, sometimes, the urge gets the better of me.”
There’s a good reason to leave your plaques alone, says Daniel Friedmann, a board-certified dermatologist at Westlake Dermatology in Austin, Texas. “Some people, purely out of habit, pick at their skin. Over time, this always makes the peeling and flaking worse,” he explains. “Stopping the itching and reducing the scratching is critical.”
Picking or peeling your skin can actually make psoriasis worse by leading to a flare-up. This is known as the Koebner phenomenon: In some people who have psoriasis, a new lesion may appear whenever their skin gets irritated or injured. Doctors believe this phenomenon happens to one out of four people who have the condition, and the amount of trauma required to trigger the response can actually be very small. In other words, it doesn’t require a deep cut or a serious scrape. Simply rubbing at the skin may lead to a lesion.
Thankfully, there are ways to stop yourself from scratching and picking your skin. Here are a few to try.
Soften Your Skin
During a psoriasis flare-up, Molly takes regular baths. “The water softens and loosens dead skin, which makes it easier to remove,” she says. “I sit in a lukewarm bath with Dead Sea salts for 15 minutes, then pat my skin dry and apply a rich emollient moisturizer to my entire body. Then I put on long-sleeved pajamas. If my skin is covered up, I’m less likely to pick at it out of habit.”
Friedmann advises moisturizing the skin on a schedule; i.e., at multiple set times during the day. This can make the skin less dry and thus improve and prevent peeling and flaking, which can help reduce the temptation to pick. He recommends SkinMedica Rejuvenative Moisturizer for this purpose, but says that countless other moisturizers will make dramatic improvements to the skin, provided they are used properly and frequently.
Apply Anti-Itch Lotion
Friedmann also recommends the OTC products Itch-X Fast-Acting Anti-Itch Gel and Sarna Sensitive Anti-Itch Lotion, which both contain pramoxine hydrochloride. “This ingredient helps to significantly and quickly reduce itching,” Friedmann says. The theory? The less you itch, the less you pick.
If there are parts of your body that you’re particularly prone to picking, such as easily-accessible areas like the backs of your hands, elbows or knees, Friedmann suggests keeping the area covered with a bandage or occlusive dressing—one that’s air- and water-tight as a good short-term solution.
While picking at your psoriasis plaques is something you should avoid doing as much as possible, sometimes that dead skin does have to come off. Molly finds that the best time to do this is in the bath. “I soak for around 10 minutes first, then carefully remove the dead skin with a washcloth. I go really gently, to make sure I don’t damage the new skin underneath. And then I apply a rich emollient moisturizer, as always.”
Another tip for removing dead skin without resorting to picking and peeling comes from James Wilson, 48, from Baltimore, Maryland. He applies a thick layer of thick moisturizer or petroleum jelly to affected areas, then covers them with plastic wrap. “I leave it on for a few hours, and when I take it off my skin is much smoother,” he says. “I tend to do it in the evening before bed or at home on weekends, so it doesn’t interfere with my life too much. It’s a little time-consuming, but it really works.”
For small, localized areas of plaque, James applies a salicylic acid preparation. Don’t overdo this, since the National Psoriasis Foundation warns that the body may absorb too much salicylic acid if it’s used over large areas of the skin. Salicylic acid is also known as a keratolytic, or peeling agent, and it works by softening a protein in the skin called keratin. When the bonds between skin cells are weakened, the outer layer of skin sheds more quickly. “I use salicylic acid on really small, stubborn, thick plaques that refuse to budge,” James says.
Unfortunately, the urge to pick and peel your skin can come with the territory when you have psoriasis. But by trying some of these tried-and-tested methods and pro tips, you might find yourself better equipped to resist temptation.